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WO2010017377A1 - Dispositif de distribution de ciment avec créateur de cavités intégré - Google Patents

Dispositif de distribution de ciment avec créateur de cavités intégré Download PDF

Info

Publication number
WO2010017377A1
WO2010017377A1 PCT/US2009/052987 US2009052987W WO2010017377A1 WO 2010017377 A1 WO2010017377 A1 WO 2010017377A1 US 2009052987 W US2009052987 W US 2009052987W WO 2010017377 A1 WO2010017377 A1 WO 2010017377A1
Authority
WO
WIPO (PCT)
Prior art keywords
blade
cannula
access cannula
cement
stylet
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2009/052987
Other languages
English (en)
Inventor
Frank J. Cinder
Jared P. Coffeen
Ryan Vanleeuwen
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Stryker Corp
Original Assignee
Stryker Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Stryker Corp filed Critical Stryker Corp
Publication of WO2010017377A1 publication Critical patent/WO2010017377A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • A61B17/1617—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1671—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B2017/32004—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes having a laterally movable cutting member at its most distal end which remains within the contours of said end

Definitions

  • the present invention relates generally to a device for creating a cavity in bone. More particularly, the present invention is directed to a tool for creating a cavity within a vertebra or other bone and through which bone cement or other filler material can be percutaneously injected into the cavity to stabilize the bone.
  • the spine which forms the backbone of a person, consists of a number of individual bones known as vertebrae.
  • a vertebra can be subjected to a compression fracture in which the normal shape of the bone becomes compressed and distorted. Compression fractures can occur as result of osteoporosis, a disease that results in a loss of normal bone density and/or mass. Trauma to the spine or other diseases can also cause compression fractures. The fracture of one or more vertebrae can result in extreme back pain. Other end effects of a vertebral fracture include decreased patient height and spinal deformity.
  • Vertebroplasty is a medical procedure in which bone cement is percutaneously injected into the fractured vertebra to stabilize the vertebra.
  • the main goal of vertebroplasty is to reduce pain caused by the fracture (s) by stabilizing the bone.
  • An undesirable side effect of vertbroplasty procedure is that the bone cement injected into a vertebra has been known to leak. This leaked cement can have undesirable effects on the other tissue and organs internal to the patient. To minimize this leakage, medical practitioners have been known to minimize as much as possible the volume of cement that is injected in the bone. This can result in too little cement being injected in the bone to have the desired therapeutic effect.
  • An alternative procedure for treating vertebral fractures that is related to vertebroplasty is kyphoplasty.
  • a kyphoplasty procedure involves placement of a balloon into a collapsed vertebra, inflating the balloon to compress the cancellous tissue internal to the bone in order to create a void. Once the void is created, bone cement is injected into the void to stabilize the fracture. Many patients have experienced appreciable relief after undergoing a kyphoplasty procedure. However, when performing a kyphoplasty procedure, it can be difficult to control where within the vertebral bone the balloon inflates. This makes it difficult to control exactly where in the bone the void is created. Consequently, it is possible that the void will be created in space occupied by previously healthy bone or that the void may not be positioned at the location at which the injected cement will have the most effect in stabilizing the fracture .
  • the cavity creator includes an outer or access cannula, an inner or cement cannula, a blade and a knob.
  • the blade is retracted within the cavity creator while the cavity creator is inserted in the vertebra or other tissue.
  • the knob is rotated, the cement cannula longitudinally translates relative to the access cannula. Translation of the cement cannula pivots the blade about a pivot pin, extending the blade radially outward of the cannulae.
  • the cavity creator is rotated to cause a like rotation of the blade. The rotation of the blade against the bone scrapes the bone so as to form a cavity.
  • the cavity creator of the instant invention does not require the practitioner to first insert the device into the patient and then insert the blade through the lumens or cannulas to create the cavity. Eliminating this step simplifies the procedure and reduces the overall amount of time it takes to perform the procedure.
  • Figure 1 is a perspective view of the cavity creator inserted into a patient's vertebra
  • Figure 2 is an assembly view of the cavity creator
  • Figure 3 is an exploded view of the cavity creator
  • Figure 4 is a perspective view of the distal end of the access cannula
  • Figure 6 is a cross-sectional view of the handle shown in Figure 5;
  • Figure 7 is cross-sectional view of the cavity creator through the handle along a plane perpendicular to the longitudinal axis of the cavity creator;
  • Figure 8 is a perspective view of the cement cannula with the luer hub attached;
  • Figure 9 is a cross-sectional view of the luer hub shown in Figure 8.
  • Figure 10 is a longitudinal perspective view of the distal end of the cement cannula shown in Figure 8;
  • Figure 11 is a perspective view of one embodiment of the blade;
  • Figure 13 is a perspective assembly view of the pivot pin and blade positioned within the cement cannula;
  • Figure 14 is a cross-sectional view of the cement cannula, blade, and pivot pin shown in Figure 13;
  • Figure 15 is a side perspective view of the distal end of the cavity creator showing the blade seated within the tip and access cannula;
  • Figure 16 is an exploded view of the proximal end of the cavity creator
  • Figure 18 is a perspective view of one (1) half of the knob in which the inner portion can be viewed;
  • Figure 19 is a perspective view of one (1) half of the knob in which the outer portion can be viewed;
  • Figure 20 is a perspective view of the stylet, including the luer cap;
  • Figure 21 is a cross-sectional view of the luer cap shown in Figure 20;
  • Figure 22 is a perspective view of the handle cap;
  • Figure 23 is a perspective view of the cement cannula in which the blade is deployed;
  • Figure 24 is a perspective view of the distal end of the access cannula in which the blade is deployed;
  • Figure 25 is a flowchart representing one embodiment of a method of using the cavity creator
  • Figure 26A is a cross sectional view of a bone where the cavity creator of this invention is in the bone forming a cavity;
  • Figure 26B is a cross sectional view of the bone after the cavity was created
  • Figure 26C is a cross sectional view of the bone wherein a plume of cement is discharged from the cavity creator into the cavity;
  • Figure 27 is a side view of an alternative luer hub of this invention.
  • Figure 28 is a perspective view of the underside of an alternative stylet cap of this invention.
  • Figure 29 is a cross sectional view of how the stylet cap of Figure 28 engages the luer hub of Figure 27.
  • FIG. 1 is a perspective view of cavity creator 100 of this invention inserted into vertebra 55 of a patient 50.
  • Cavity creator 100 comprises handle 110, knob 140, and an outer tube, access cannula 160. Distal end 164 of access cannula 160 is inserted into patient's 50 vertebra 55.
  • Handle 110 and knob 140 are located at the proximal end of access cannula 160.
  • FIGs 2 and 3 illustrate cavity creator 100 in which handle 110, knob 140, access cannula 160, and handle cap 180 can be seen.
  • Access cannula 160 is a substantially hollow elongated tube and comprises proximate end 162 and an opposed distal end 164.
  • Handle 110 is rigidly secured to proximal end 162 of access cannula 160.
  • Tip 170 is attached to the distal end of an inner tube, cement cannula 200 (see Figure 13) .
  • Tip 170 extends forward from distal end 164 of access cannula 160. Tip 170 functions as the component that punctures the patient's skin and vertebra or other bone into which cavity creator 100 is inserted.
  • the cement cannula 200 has a lumen 202 that extends axially therethrough (see Figure 13) .
  • the cement cannula 200 is positioned substantially within the access cannula 160.
  • Blade 210 is pivotally connected to access cannula 160 and seated within cement cannula 200.
  • Stylet 230 is a substantially solid elongated rod that is removably positioned within cement cannula 200. Handle cap 180 keeps stylet 230 within cavity creator 100 until the practitioner intends to remove stylet 230 from cavity creator 100.
  • knob 140 When knob 140 is rotated about Axis A, cement cannula 200 functions as a drive member by being longitudinally displaced relative to access cannula 160. This displacement of the cement cannula 200 pushes the pivoting blade 210 against the access cannula. This displacement of blade 210 causes the blade to rotate about pivot pin 220 to extend blade 210 radially outward from cavity creator 100. Cavity creator 100 is then rotated and/or raised and lowered so that blade 210 can scrape the bone to create the cavity.
  • knob 140 is made of Nylon 6 6 plastic as manufactured by EMS- Grivory of Sumter, South Carolina, but can be made of any material commonly known and used in the art having similar characteristics .
  • Handle cap 180 extends over knob 140 and is removably secured to handle 110 to prevent removal of stylet 230 and rotation of knob 140. Handle cap 180 also allows the practitioner to use a hammer or other device to aid in inserting cavity creator 100 into the vertebra without damaging the other components of cavity creator 100. Handle cap 180 is made of the same material as knob 140, but can also be made of another material and need not be made of the same material as knob 140.
  • FIG. 4 illustrates distal end 164 of access cannula 160.
  • Center bore 158 extends end-to-end through access cannula 160.
  • a pair of diametrically opposed, rectangularly shaped slots 159 extend proximally rearward from distal end 164 of access cannula 160. Each slot 159 is contiguous with access cannula bore 158.
  • a pair of holes 153 is formed in access cannula 160 between the slots. Holes 153 are located immediately forward of proximal end 164 of slot 159. Holes 153 are centered on a line located above the longitudinal axis of access cannula bore 158.
  • FIGS 5 and 6 illustrate handle 110.
  • Handle 110 has a cylindrical neck 114 that forms the distal end of handle 110. Above neck 114, handle 110 is formed to have cylindrical core 112. Core 112 has an outer diameter greater than that of neck 114.
  • a single arcuately shaped shoulder 113 extends outwardly from an outer surface of core 112. Shoulder 113 has a distal end (not identified) that is V-shaped and directed towards the distal end of cavity creator 100. More particularly, shoulder 113 is located on handle 110 so that the distally base of the shoulder points to access cannula slot 159 from which blade 210 emerges.
  • the proximal end of core 112 has a flat shape .
  • Two opposed steps 108 formed integrally with core 112 extend upwardly from the opposed sides of the proximal end of core 112. Steps 108 have a length greater than that of the diameter of core 112 such that each step 108 extends outwardly from core 112.
  • One (1) tab 116 extends upwardly from each step 108.
  • Each tab 116 generally has a cross- sectional shape of slice section through the end of a circle. Tabs 116 are located so that each tab 116 is slightly set back from the horizontal surface-vertical surface edge of step 108 with which tab 116 is integral.
  • Each tab 116 is further formed to have around top surface 117 a lip 106 that projects outwardly around the curved outer surface of tab 116.
  • Opposed arms 118 project outwardly from handle core 112.
  • Each arm 118 is in the form of a three-section structure (individual sections not identified) .
  • a first section of each arm 118 projects outwardly from the distal end of core 112, adjacent handle neck 114.
  • a second section of an individual arm 118 extends upwardly from the outer end of the first section.
  • Each arm 118 has a third section that extends inwardly from the top of the second section.
  • the third section of each arm 118 curves downwardly and connects to the adjacent step 108.
  • the first and second sections of each arm 118 are generally planar structures.
  • the third section of each arm 118 is formed to so that as arm 118 approaches adjacent step 108, the thickness of arm 118 increases .
  • a downwardly extending recess 120 is formed in the top surface of the third section of each arm 118.
  • handle 110 is shaped so that each recess 120 is defined by abutting horizontal and vertical surfaces on arms 118 (surfaces not identified) .
  • Handle 110 is further formed to define groove 102 in each recess-defining vertical surface of arm 118.
  • Each groove 102 extends the width of the vertical surface and is located a short distance above the horizontal surface that defines the base of recess 120.
  • Finger 101 extends inwardly from the third section of each arm 118. Each finger 101 extends from the surface of the associated arm 118 that curves downwardly towards the end of the adjacent step 108. Fingers 101 project over and above the horizontal surface of the adjacent steps 108.
  • Handle 110 is further formed with a stop 130 ( Figure 16) .
  • Stop 130 is in the form of a rectangular and planar shaped web that extends downward from one finger 101 to the horizontal surface of the step 108 below the finger. More particularly, stop 130 is located above the step 108 opposite the step 108 in which grooves 127 and 128 are formed. Stop 130 should also be understood to project outwardly from the vertical wall (not identified) that extends between the associated finger 101 and step 108.
  • Handle 110 is further formed to have a pair of opposed webs 104. Webs 104 extend outwardly from opposed surfaces of handle core 112. Each web 104 extends bottom- to-top from the opposed surfaces of handle arm 118 first and third surfaces between which web 104 is located.
  • First and second contiguous and coaxial bores 122 and 124 extend through handle core 112 and neck 114. Bore 122 extends downwardly from the top surface of handle core 112. (Not identified is the small tapered counter bore that forms the actually opening in core 112 top surface.) Bore 122 has a diameter that allows cement cannula 200 to slidably move within the bore 122. The distal end of bore 122 opens into bore 124. Bore 124 extends from bore 122 to the distal end of handle neck 114. Bore 124 has a diameter greater than that of bore 122. More particularly, bore 124 has a diameter that allows access cannula 160 to be seated and secured in bore 124. In some versions of the invention, access cannula 160 is heat staked, overmolded, or adhesively secured in bore 124
  • Luer hub 240 is secured to proximal end 206 of cement cannula 200.
  • luer hub 240 is formed from a single piece of plastic that is shaped to have base 242 and head 244 coaxial with base 242. Both base 242 and head 244 are generally cylindrical. Head 244 is located above base 242 and has an outer diameter slightly greater than that of base 242. A first bore 247 extends upwardly from the distal end of base 242.
  • Bore 247 is dimensioned to receive the proximal end of cement cannula 200. Bore 247 extends approximately one quarter the way up luer hub 240 from the bottom of hub base 242. A second bore, bore 248, extends upwardly through hub base 242 from bore 247 towards the top end of hub base 242. Bore 248 has a diameter less than that of bore 247. More particularly, bore 248 has a diameter that allows stylet 230 to be slidably advanced/retracted through bore 248. Luer hub 240 has a third bore, bore 249, that extends upwardly from second bore 248. Bore 249 has a diameter greater than the diameter of stylet 230. Third bore 249 is located in and extends axially through hub head 244.
  • Bore 249 has a diameter that is greater than the diameter of bore 248. (Not identified is the sloped surface between second bore 248 and third bore 249. In some versions of the invention, bore 249 also has a diameter greater than that of bore 247. While not readily visible in the Figures, third bore 249 is also tapered inward along its length from its proximal end to its distal end. The taper allows luer hub 240 to connect to a luer fitting of a standard syringe or other medical device. For example, while the distal end of tube 42 is not shown, this tube would have a fitting that allows the tube to be connected to luer hub 240.
  • tip 170 is also formed to have blade slot 216 that is located proximal to tip head 212 and forward of discharge port 266.
  • Blade slot 216 extends through tip 170 from the top to the bottom.
  • tip 170 is formed so that the longitudinal axis of discharge port 266 lies in the longitudinal plane around which slots 216 and 218 are centered.
  • Discharge port 266 is centered along a plane that is perpendicular to the longitudinal plane around which slots 216 and 218 are centered.
  • supplemental slot 218 does not extend completely through the opposed top and bottom sides of tip 170.
  • Blade 210 is formed from material such as 17-4 pre-hard, heat treatable stainless steel, but can also be made of any commonly known and used material in the art having similar characteristics.
  • Blade 210 comprises body 222 that has a generally planar shape. Body 222 has main section 225 that has a top-to-bottom height substantially equal to the outer diameter of access cannula 160.
  • Body main section 222 has a leading edge 228 that has a curved cross-sectional profile.
  • Body main section 222 has trailing edge 229 (see Figure 14) .
  • the leading and trailing edges, 228 and 229 respectively, of blade 210 have a common radius of curvature substantially equal to the radius of curvature of access cannula 160.
  • Blade body 225 has distal face 227 is the most distally directed surface of the blade body 225. Distal face 227 extends between the opposed sides of the blade body 225. Face 227 generally has a rounded shape. Face 227 is further formed to have a planar taper 231 that extends forward from the distal end of trailing edge 229. Taper 231 provides clearance for blade 210 so the blade can rotate in and out of tip blade slot 216.
  • Blade body 225 is further formed to have a tail 270 that extends rearward and is coplanar with main section 225.
  • Tail 270 has a top to bottom height less than that of body main section 225. More particularly, blade 210 is shaped so that when blade main section 225 seats in blade slot 216, blade tail 270 seats in supplemental slot 218 and tail 270 extends into the void space subtended by tip notches 224. The upper edge of blade tail 270 is located below leading edge 228 of main section 225.
  • Blade tail 270 further comprises tapered corners 273 located forward of the proximal end of blade tail 270.
  • FIG 12 is a perspective view of pivot pin 220.
  • Pivot pin 220 is substantially cylindrical and comprises two (2) opposing outer surfaces 238. Outer surfaces 238 are slightly arcuate to correspond to the rounded outer surface of access cannula 160. While not apparent in the drawings, pivot pin 220 is slightly tapered along its length, with the diameter of the of one end being slightly larger than the diameter of the opposed end.
  • pivot pin 220 extends through blade throughhole 276.
  • Blade 210 is positioned in tip 170 so that body main section 225 of blade 210 seats in tip blade slot 216 and body tail 270 seats in supplemental slot 218.
  • the opposed side edges of blade 210 project beyond the outer circumferential surface of tip 270.
  • each post 278 seats in an adjacent tip slot 226.
  • the opposed ends of pivot pin 220 extend through and over and beyond notches 224.
  • the arcuately shaped opposed outer surfaces 238 of pivot pin 220 are flush with the outer circumferential surface of access cannula 160.
  • distal end 164 of cement cannula 200 and the portion of tip 170 proximal to head 212 are seated within access cannula bore 158.
  • Tip blade slot 216 is in registration with the opposed access cannula slots 159.
  • the opposed ends of pivot pin 220 are fixedly secured via press fit in the opposed access cannula holes 153.
  • One access cannula hole 153 is slightly larger than the other such that each end of pivot pin 220 can be press fit within each access cannula hole 153.
  • blade 210 Owing to the relative dimensioning of access cannula 160 and blade 210, when in the retracted position (for example, as shown in Figure 15), blade 210 is substantially flush with access cannula 160 so as not to catch on tissue when cavity creator 100 is inserted into the patient. Also visible in Figure 15 is tapered surface 284 around the distal end of tip 170. Tapered surface 284 is angled inward between the diameter of access cannula 160 and approximately the outer diameter of head 212. Tapered surface 284 further reduces the likelihood of access cannula 160 catching tissue when cavity creator 100 is inserted in the patient.
  • the maximum distance the distal end of the tip head 214 and the proximal ends of slots 224 is no greater than 0.200 inches. In more preferred versions of the invention, this maximum separation between these two features of tip 170 is no more than 0.150 inches. In turn, this makes it possible to fabricate tip 170 so that the cement discharge port 266 opens within 0.250 inches of the distal end of the tip and, in more preferred versions of the invention, within 0.200 inches of this end.
  • bore 214 should be relatively wide to facilitate the discharge of cement with as free as flow as possible. In some versions of the invention bore 214 should have a diameter of at least 0.050 inches.
  • FIGs 16 and 17 are exploded and cross-sectional views, respectively, of the proximal end of cavity creator 100.
  • Knob 140 is shaped to have a body 142 and two (2) downwardly extending rings 146, 148.
  • the first ring 146 extends downward from the outer portion of the bottom surface of body 142.
  • the second ring 148 extends downward from the center of the bottom surface of body 142 and forms bore 150.
  • First ring 146 is outward of second ring 148, which are separated by gap 152.
  • Second ring 148 comprises two (2) sections (not identified) .
  • the first section is proximate to knob body 142.
  • the second section is below the first section and has a smaller diameter than the first section.
  • First ring 146 comprises inwardly extending lip 256.
  • tabs 116 of handle 110 extend upward into gap 152.
  • Lip 256 is disposed below the outwardly projecting lips 106 integral with handle tabs 116. The lip-under-lip arrangement allows knob 140 to rotate, but does not allow it to be upwardly removed from handle 110.
  • knob 140 comprises two (2) matable halves.
  • the male half of knob 140 includes six (6) mating members 156.
  • the female half (not shown) includes six (6) corresponding receiving members for engaging mating members 156.
  • Mating members 156 and the corresponding receiving members are press fit together.
  • the two (2) halves of knob 140 can alternately be secured to one another by a greater or lesser number of mating members 156 and receiving members, by heat, an adhesive, screws, or any combination thereof.
  • FIGs 18 and 19 one half of circular opening 138 formed in the top of knob body 142 can be seen. Opening 138 is dimensioned to receive luer cap 260.
  • Knob body 142 is further shaped to have notch 144 that extends radially outwardly from opening 138. Notch 144 is sized to allow luer cap tab 255 (see Figure 21) to pass therethrough when properly aligned in order to remove stylet 230.
  • Each half of knob 140 includes one half of slot 134 such that when mated, the halves form slot 134.
  • Slot 134 is formed as part of knob top surface 136 and that part of top surface 136 forming slot 134 has a thinner thickness as compared to the remaining portion of knob top surface 136.
  • Slot 134 extends along the opposing inner facing mating surfaces of each half of knob 140 and extends from the outer edge of opening 138 to the outermost edge of knob 140. Slot is further oriented substantially perpendicular to notch 144.
  • the other half of knob 140 has a corresponding half detent 288 that, when the two (2) halves of knob 140 are mated, form a full detent 288.
  • each half further includes a second half detent 288 on the opposite mating side (not visible) .
  • the result is four (4) full detents 288.
  • Detents 288 are all spaced apart from one another at approximately ninety degree ( 90 ) increments .
  • Ribs 286 are also visible on the outside of body 142. Because the practitioner may be wearing gloves and/or have fluids on their hand, ribs 286 allow the practitioner to better grip knob 140. Knob 140 can have any number of ribs 286, and it is not intended that ribs 286 be limited to any width, depth, spacing between, or orientation. As an alternate gripping mechanism, knob 140 can further include studs, textured portion (s) , an elastomeric material positioned on any portion or entirely around knob 140, or any combination thereof.
  • Slot 290 is formed in first ring 146 and extends circumferentially around an outer section of ring 146. Each half that forms knob 140 is formed with slot 290. Slots 290 are present for manufacturing reasons and are otherwise not relevant to this invention. Corners 292, 293 are rounded surfaces where each vertical surface meets the horizontal surfaces of rings 146, 148. The rounded surfaces are also not integral to the invention.
  • Knob second ring 148 is further formed to have a single outwardly extending rib 172 seen best in Figure 19.
  • Rib 172 is dimensioned to fit in handle grooves 127 and 128. More particularly, rib 172 has a radius of curvature that is less than the radius of curvature of groove 127.
  • Knob 140 is further formed to have a single tab 235, seen in cross section in Figure 17. Tab 235 extends radially outwardly from the distal end of knob first ring 146.
  • Figure 20 shows stylet 230, including luer cap 260. Stylet 230 is a substantially solid rod and comprises distal end 234 and proximal end 236.
  • Stylet 230 has an outer diameter that allows stylet 230 to slip fit within cement cannula lumen 202.
  • Luer cap 260 is fitted over and secured to proximal end 236 of stylet 230.
  • Plug 232 is secured to distal end 234 of stylet 230 and made of a flexible material. Stylet 230 and plug 232 are collectively shaped so that plug 232 extends forward of cement cannula 200.
  • Stylet 230 is shaped so that the distal end of the stylet does not extend into tip 170.
  • stylet 230 When stylet 230 is positioned within cement cannula 200, at least a portion of stylet plug 232 extends through tip bore 214 towards the access cannula discharge port 166. Stylet plug 232 does not extend out of the access cannula discharge port 166.
  • This design feature substantially eliminates the possibility that, when the cavity creator 100 is inserted in the patient, tissue will catch in discharge ports 166 and 266. Stylet 230 is held in place by the frictional engagement between stylet plug 232 and bore 214 to prevent rotation of stylet 230. Because stylet plug 232 is made of a flexible material, it can be slid along lumen 202 of cement cannula 200 and bend off axis from the stylet 230 to extend into tip bore 214.
  • Stylet plug 232 is made of an elastomeric material such as that manufactured under the trademark Santoprene® by Advanced Elastomer Systems of Akron, Ohio but can be made of any other natural or man-made material having similar flexibility, durability, and biocompatibility characteristics, including silicone.
  • Stylet 230 is made of 316 stainless steel, but can alternately be made of another sufficiently corrosion-resistant, biocompatible, and strong material, including but not limited to 420 stainless steel, 304 stainless steel, and 17-4 pre-hardened stainless steel.
  • Luer cap 260 is made of the same material as handle 110, but can also be made of any material commonly known and used in the art having similar characteristics.
  • Luer cap 260 is generally cylindrical and comprises body 262, outer skirt 267, inner skirt 268, recess 258 between skirts 267, 268, tab 255, and luer boss 280.
  • Body 262 is substantially cylindrical.
  • Luer boss 280 is integrally formed with and positioned on the proximal end of luer body 262.
  • Boss 280 is also substantially cylindrical in shape and extends outward from body 262.
  • Luer boss 280 also extends upward beyond the top surface of knob 140 when stylet 230 is positioned within cavity creator 100. Luer boss 280 allows the practitioner to grasp luer cap 260.
  • outer skirt 267 and inner skirt 268 are outer skirt 267 and inner skirt 268.
  • Outer skirt 267 is positioned outward of luer body 262 to approximately the same diameter as luer boss 280 and extends downward from body 262.
  • Inner skirt 268 extends downward from body 262 below outer skirt 267.
  • Inner skirt 268 is further formed to have a tapered outer diameter that increases from the distal end of skirt 268.
  • Inner skirt 268, body 262, and a portion of boss 280 also form a generally cylindrical bore 264. Bore 264 is sized to receive proximal end 236 of stylet 230. Luer cap 260 is overmolded onto stylet 230.
  • Cap 180 extends radially outward from outer skirt 267 and prevents stylet 230 from being unintentionally removed from lumen 202. Specifically, in order to remove stylet 230, tab 255 must be aligned with notch 144 (see Figure 18) in top surface 136 of knob 140.
  • Figure 22 illustrates cap 180.
  • Cap 180 can be made out of the same material from which handle 110 is formed.
  • Cap 180 is formed as a single piece component shaped to have head 182 in form of a flat surfaced dome. As seen best in Figure 17, the undersurface of head 182 is shaped to have cavity 184. Cavity 184 is dimensioned to receive the top of luer cap 260.
  • Each arm 186 extends radially outwardly from the opposed sides of head 182.
  • Each arm 186 is generally in the form of a bar that curves downwardly as arm 186 extends away from head 182.
  • Extending downwardly from the undersurface of each arm 186 is rib 188.
  • Ribs 188 have a side-to-side width less than arms 186 from which ribs 188 extend. Ribs 188 mate with slot 134 on top surface 136 of knob 140 to prevent rotation of knob 140 until knob cap 180 is removed.
  • Fingers 190 extend downwardly from the undersurface of each arm 186. Fingers 190 are located inwardly of the outer ends of each arm 186. Each rib 188 abuts the end of the associated finger 190. Fingers 190 are formed to have a T-shaped cross sectional profile such that each finger 190 has flange 192. Cap 180 is further shaped so that finger flanges 192 are directed inwardly, towards each other. Flanges 192 provide structural support for when cavity creator 100 is hit with an impact device. Knuckles 195 extend outwardly from each finger flange 192. Knuckles 195 are thus directed inward toward each other. Each knuckle 195 is in the shape of a triangle that has a notch that extends inwardly from the apex (notch not identified) .
  • handle cap 180 is shaped so that when handle cap 180 is seated over the rest of cavity creator 100, as seen in Figure 17, there is first gap 174 between the top of luer cap 260 and the adjacent undersurface of cap head 182. There is also a smaller and outwardly directed second gap 176 between ribs 188 below each arm 186 and top surface 136 of knob 140.
  • cavity creator 100 can be used by performing the following steps. It should be noted that not every step need be included in every procedure involving cavity creator 100 and that additional and/or equivalent steps can be included without departing from the spirit and scope of the invention.
  • Figure 25 is a flowchart representing one (1) method 300 of using cavity creator 100 of the instant invention.
  • the following steps can be performed: inserting the cavity creator 310, extending the blade 320, creating a cavity 330, retracting the blade 335, withdrawing the stylet 340, connecting the cavity creator to a canister 350, injecting cement or another material into the cavity through the cavity creator 360, and removing the cavity creator 370.
  • knob detents 288 are seated in handle finger grooves 126.
  • Knob rib 172 is, at this time, seated in handle groove 127.
  • Step 310 comprises inserting cavity creator 100 into vertebra 55 or other bone tissue, whether additional tissue must be traversed (for example, through skin over vertebra 55) or vertebra 55 or other bone is exposed.
  • a small incision is made to form an opening in the skin at which the cavity creator 100 is to be inserted.
  • the actual insertion is typically done by hand, but a hammer or other impact device can also be used to insert cavity creator 100. During this process the head of the hammer is brought down against cap head 182. The force of this impact is transferred through cap arms 186 and fingers 190 to handle 110. From handle 110, the force is transmitted through access cannula 160 to tip 170.
  • blade 210 is in the retracted state, the longitudinal axis of the blade is at least parallel to, if not aligned with, the longitudinal axis of access cannula 160.
  • stylet tip 232 is disposed in tip bore 214. The presence of tip 232 in bore 214 during the insertion process reduces the likelihood that, during the insertion process, tissue will catch in the access cannula discharge port 166 or tip bore 214.
  • step 320 handle cap 180 is first removed from the rest of cavity creator 100.
  • the removal of cap 180 moves cap ribs 188 away from knob slot 134.
  • the practitioner may rotate cavity creator 100 so blade 210 will extend into the specific section of bone in which the cavity is to be formed.
  • the longitudinal axis of the blade becomes angled relative to the longitudinal axis of the access cannula 160.
  • cavity creator 100 is rotated until the base of handle shoulder 113 points to the section of the bone into which the practitioner wants blade 210 to extend.
  • Blade 210 is extended by rotating knob 140.
  • knob 140 When knob 140 is turned, the inner or cement cannula 200 longitudinally translates relative to the outer or access cannula 160. Pivot pin 220 is fixed relative to access cannula 160, and blade 210 is positioned within cannulas 160, 200.
  • cement cannula 200 and tip 170 are longitudinally translated forward, the rear surfaces of tip 170 that define slots 226 are pushed against posts 278 on blade 210, as seen in Figure 23. This action pushes blade 210 outwardly so that blade 210 rotates around pivot pin 220 and extends out of one of the access cannula slots 159 as seen in Figure 24.
  • knob 140 also rotates knob notch 144 so that the notch moves out of registration with stylet cap tab 255.
  • This new orientation of knob 140 relative to luer cap tab 255 places knob 140 in the position in which knob 140 blocks removal of luer cap tab 255 and therefore the whole of stylet 230, from the rest of cavity creator 100.
  • the plug 232 is in an off axis position to stylet 230 itself.
  • This off axis position of stylet plug 232 inhibits the manual rotation of stylet 230 that could place luer cap tab 255 in registration with knob notch 144.
  • the inhibiting of the rotation of stylet 230 and the reorientation of knob 140 mean that when knob 140 is rotated to extend blade 210, stylet 230 is blocked from removal from the rest of the assembly.
  • Detents 288 provide an indication of the extent to which knob 140 is rotated from the initial state so as to provide an indication of the degree of blade extension. Specifically, once knob 140 is rotated 90° from the initial state, a second pair of opposed detents 288 seat in handle grooves 126 to provide an indication of the quarter-turn rotation of knob 140. This means that the blade 210 is extended approximately one-quarter from its retracted state. The rotation of knob 140 180° results in the opposed pair of detents 288 that were initially seated in the handle grooves 126 reseat in the grooves.
  • each detent 288 seats in a groove 126 opposite the groove 126 in which the detent 288 was initially seated.
  • This seating of detents 288 provides tactile feedback that knob 140 has undergone a half turn of rotation.
  • the second pair of opposed detents 288 again seat in handle grooves 126.
  • the movement of detents 288 in and out of grooves 126 provides the indication that knob 140 has undergone more that a three-quarters turn rotation. It should therefore be understood that the blade 210 should be considered about three-quarters fully extended.
  • knob 140 is not rotated a full 360°. Instead, the knob is able to rotate between typically between 330° and 350°. In some versions of the invention, the knob is able to rotate between 340° and 345°.
  • knob rib 172 seats in handle groove 128. The seating of rib 172 in groove 128 provides the tactile feedback that the knob is fully rotated. Should one try to force further rotation of knob 140, knob tab 235 abuts handle stop 130 to prevent such movement.
  • blade 210 is extended, the cavity is created in the bone, step 330. This step is performed by the practitioner rotating cavity creator 110.
  • This rotation causes blade 210 to move against and scrape the porous cancellous tissue 306 that forms the center of the bone 302 as seen in Figure 26A.
  • the dense cortical tissue 304 that forms the outer shell of bone 302 is represented by dense stippling; the inner porous cancellous tissue 306 is represented by sparse stippling.
  • the grinding of the cancellous tissue 306 forms a cavity 308 in the bone 302 where this tissue was previously located.
  • the practitioner is able to selectively control where in the bone 302 the cavity 308 is created by regulating the arc through which blade 210 is rotated. The practitioner monitors blade position by monitoring the location of the distally directed base of the handle shoulder 113.
  • Cavity creator 100 can be completely rotated to form a 360° cavity around cavity creator 100 or can be rotated to an extent less than complete rotation to create a cavity only around a portion of cavity creator 100. Cavity creator 100 can, while being rotated, also be moved longitudinally to create a cavity that is longer than the length of blade 210.
  • stylet plug 232 is disposed is disposed in tip bore 214.
  • Plug 232 prevents tip bore 214 and cement cannula lumen 202 from clogging, which could inhibit the subsequent delivery of cement.
  • tip discharge port 266 moves out of registration with the access cannula discharge port 166. More particularly, the section of the tip 170 proximal to discharge port 266 moves under the access cannula discharge port 166. This further blocks the flow of material into tip bore 214 and cement lumen 202.
  • blade 210 is retracted, step 335, by reversely rotating knob 140.
  • the rotation of knob 140 causes cement cannula 200 to retract proximally rearward. This results in blade pins 278 being pressed against the surfaces of tip 170 that define the distal ends of slots 226. The pressing of the blade pins 278 against these surfaces rotates blade 210 about pivot pin 220 to the retracted position.
  • knob notch 144 is rotated back into alignment with luer cap tab 255.
  • stylet 230 can be removed form cavity creator 100, step 340.
  • Step 350 comprises connecting cavity creator 100 to cartridge 40. Bone cement or other filler material to be injected into the cavity is contained in cartridge 40. Cartridge 40 is mechanically connected to cavity creator 100 by flexible tubing 42 or other appropriate means. As shown herein, flexible tubing 42 is connected to cavity creator 100 by a threaded fitting (not shown) on flexible tubing 42 that mates with threading 254 on luer hub 240. [000117] Step 360 comprises injecting the bone cement or other filler material into to the cavity. The material is ejected from cartridge 40 using plunger 44, but can be ejected using any other mechanism or device.
  • the ejected material passes through flexible tubing 42, through lumen 202, cement cannula discharge port 266 and access cannula discharge port 166 into the cavity 308 as seen in Figure 26C.
  • a plume of cement 309 is seen discharged from the access cannula port 166 into the cavity 308.
  • the mass of cement fixates fractures present in the bone.
  • the injection of other filler material into the bone cavity provides the same and/or other therapeutic benefit .
  • Step 370 comprises removing cavity creator 100 from the patient. That is, once the material has been injected into the cavity, cavity creator 100 is extracted from the bone and any other tissue that cavity creator 100 passed through to get to the bone.
  • a feature of this invention therefore is that it provides a single device for: penetrating the bone; forming the cavity in the bone; and functioning as the delivery conduit through which the filler material can then be introduced into the cavity.
  • the need to use plural instruments to perform these steps is therefore eliminated. Eliminating the need to position plural instruments in the bone both minimizes the complexity of the procedure and the overall amount of time it takes to perform the procedure.
  • step 350 of connecting cavity creator 100 to cartridge 40 can be performed between or during other steps of method 300.
  • cavity creator 100 and method of using same has been shown and described primarily with respect to one (1) specific version, from the above description it should be clear that the same is not limited thereto, but is susceptible to numerous changes and modifications as known to a person of ordinary skill in the art. There is no requirement that all versions of the invention include each of the above-described features.
  • cavity creator 100 need not include handle cap 180.
  • knob 140 need not have ribs 286 or another means for helping the practitioner grasp cavity creator 100.
  • threading 254 on luer hub head 244 is only one way by which delivery tube 42 can be attached to cement cannula 200.
  • delivery tube 42 frictionally engages luer hub 240 such that threading 254 is unnecessary.
  • the pivot pin 220 may be welded to the access cannula 160.
  • alternative means may be provided to prevent removal of the stylet 230 when the blade 210 is in the extended state.
  • cap finger 404 seats in the luer hub break 394.
  • the finger-inbreak engagement of the hub 390 and cap 402 prevents the stylet cap from rotating relative to the luer hub.
  • the knob 140 is rotated to extend the blade 210, cement cannula 200 only undergoes translation motion, the cannula 200 does not rotate. Again such rotation causes the knob notch 144 to rotate out of registration with cap tab 255. Owing to the seating of the stylet cap finger 404 in fitting break 394, the stylet cap 402 cannot be rotated to place the cap tab 255 in registration with knob notch 144.
  • alternate versions and geometries of the described features of the present invention are possible.
  • alternate versions of cavity creator 100 may vary from what has been illustrated.
  • blade 210 has been shown as having a substantially rectangular cross- sectional shape.
  • blade 210 may be triangular, hooked, or have almost any other shape depending on the specific size and shape of the cavity to be created.
  • head 212 has been shown as having four facets to form a generally pyramid shape.
  • head 212 can have any alternate shape that still allows cavity creator 100 to be inserted into the bone in which the cavity is to be formed.
  • handle 110 can have any shape that provides the practitioner the ability to grasp cavity creator 100.
  • access cannula 160 and tip 170 can be formed as one integrated element.
  • cement cannula 200 and tip 170 can be formed as one integrated element.
  • the discharge port 266 can be on the cement cannula 200 rather than on tip 170.
  • the slots stop short of the outer circumferential wall of pin 170. Adjacent each slot there is a small web. One side of the web defines a portion of the outer circumferential surface of the tip 170; the opposed surface defines the end of the associated slot.
  • the webs add strength to the tip when it is inserted into tissue or the cavity creator 100 is rotated.
  • cavity creator 100 of this invention may be used with cement or filler delivery devices other than the disclosed cartridge 40.
  • a tube shaped cartridge may be disposed in the access cannula lumen. This cartridge is preloaded with cement or filler.
  • bone filler other than cement may be supplied to the cavity created using the assembly of this invention.
  • Other potential bone fillers than cement include: bone graft material or bone growth material.
  • the fillers that can be delivered using this invention are not limited to liquids and semi-solids. Solid implants like beads or other rigid fillers may be added using the assembly of this invention .
  • a tab may be attached to the cement cannula 200.
  • the practitioner slides the tab to cause displacement of the cement cannula in order to cause the desired extension/retraction of the blade 210.
  • an elongated rod may be slidably mounted to the cement cannula 160.
  • a rack of gear teeth engage complementary teeth associated with the blade 210. The rod is extended/retracted in order to cause a similar displacement of the blade 210.
  • the cement cannula may be provided with a finger that is biased to press into a notch in the stylet when the cement cannula is displaced in the forward direction. The seating of the finger in the notch blocks removal of the stylet. When the cement cannula is retracted proximally, the finger retracts from the stylet to allow removal of the stylet.
  • the access cannula may not have a lumen. In these versions of the invention, it should be appreciated that once the cavity is created, this invention is removed and a separate delivery cannula is used as the member for introducing filler material into the created cavity.

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  • Health & Medical Sciences (AREA)
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  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • General Health & Medical Sciences (AREA)
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  • Dentistry (AREA)
  • Surgical Instruments (AREA)

Abstract

Créateur de cavités (100), comprenant une canule d’accès (160) présentant une lumière (214). Une pointe (170) capable de pénétrer dans un os s’étend vers l’avant à partir de l’extrémité distale (164) de la canule d’accès. Une lame (210) est attachée de façon mobile à la canule d’accès à proximité de la pointe de manière à se déplacer entre des états rétracté et étendu. La canule d’accès comporte un port de décharge (166) à proximité de la lame. La pointe est utilisée pour positionner le tube supérieur dans un os. La lame est étendue de manière à former une cavité dans l’os. Une fois que la cavité est créée, une matière de remplissage peut être introduite dans la cavité en faisant s’écouler la matière à travers la lumière de la canule d’accès.
PCT/US2009/052987 2008-08-07 2009-08-06 Dispositif de distribution de ciment avec créateur de cavités intégré Ceased WO2010017377A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US12/187,727 2008-08-07
US12/187,727 US8246627B2 (en) 2008-08-07 2008-08-07 Cement delivery device for introducing cement into tissue, the device having a cavity creator

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WO2010017377A1 true WO2010017377A1 (fr) 2010-02-11

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018195406A1 (fr) 2017-04-21 2018-10-25 Stryker Corporation Système de stabilisation et implant pour empêcher un mouvement relatif entre des sections de tissu
WO2020023271A1 (fr) * 2018-07-27 2020-01-30 Warsaw Orthopedic, Inc. Système et procédé d'implant rachidien
WO2023114949A1 (fr) 2021-12-16 2023-06-22 Sana Biotechnology, Inc. Procédés et systèmes de production de particules

Families Citing this family (96)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2314257B9 (fr) 2000-05-01 2013-02-27 ArthroSurface, Inc. Système de réparation de rectification de joint
US7163541B2 (en) 2002-12-03 2007-01-16 Arthrosurface Incorporated Tibial resurfacing system
US8177841B2 (en) 2000-05-01 2012-05-15 Arthrosurface Inc. System and method for joint resurface repair
US7678151B2 (en) 2000-05-01 2010-03-16 Ek Steven W System and method for joint resurface repair
US6610067B2 (en) 2000-05-01 2003-08-26 Arthrosurface, Incorporated System and method for joint resurface repair
US8419730B2 (en) 2008-09-26 2013-04-16 Relievant Medsystems, Inc. Systems and methods for navigating an instrument through bone
US8361067B2 (en) 2002-09-30 2013-01-29 Relievant Medsystems, Inc. Methods of therapeutically heating a vertebral body to treat back pain
US7901408B2 (en) 2002-12-03 2011-03-08 Arthrosurface, Inc. System and method for retrograde procedure
US8388624B2 (en) 2003-02-24 2013-03-05 Arthrosurface Incorporated Trochlear resurfacing system and method
CA2546582A1 (fr) 2003-11-20 2005-06-09 Arthrosurface, Inc. Administration retrograde de dispositifs de rechargement de surface
EP1845890A4 (fr) 2003-11-20 2010-06-09 Arthrosurface Inc Systeme et procede pour acces retrograde
EP1765201A4 (fr) 2004-06-28 2013-01-23 Arthrosurface Inc Systeme de remplacement de surface articulaire
US7828853B2 (en) 2004-11-22 2010-11-09 Arthrosurface, Inc. Articular surface implant and delivery system
US9358029B2 (en) 2006-12-11 2016-06-07 Arthrosurface Incorporated Retrograde resection apparatus and method
WO2008076330A1 (fr) * 2006-12-15 2008-06-26 Soteira, Inc. Forets et procédés pour l'implantation d'endoprothèse vertébrale
AU2008216160A1 (en) * 2007-02-14 2008-08-21 Arthrosurface Incorporated Bone cement delivery device
WO2009111481A1 (fr) 2008-03-03 2009-09-11 Arthrosurface Incorporated Système de resurfaçage d'os et procédé
US10028753B2 (en) 2008-09-26 2018-07-24 Relievant Medsystems, Inc. Spine treatment kits
US8758349B2 (en) 2008-10-13 2014-06-24 Dfine, Inc. Systems for treating a vertebral body
US8663226B2 (en) 2008-09-30 2014-03-04 Dfine, Inc. System for use in treatment of vertebral fractures
CA3064646C (fr) 2009-04-17 2023-01-03 Arthrosurface Incorporated Systeme et procede de re-surfacage de glenoide
WO2010121250A1 (fr) 2009-04-17 2010-10-21 Arthrosurface Incorporated Système et procédé de re-surfaçage de glénoïde
US10945743B2 (en) 2009-04-17 2021-03-16 Arthrosurface Incorporated Glenoid repair system and methods of use thereof
US8821505B2 (en) * 2009-04-24 2014-09-02 Kyphon Sarl Minimally invasive cement delivery system retainer
US20100298832A1 (en) 2009-05-20 2010-11-25 Osseon Therapeutics, Inc. Steerable curvable vertebroplasty drill
WO2012151573A1 (fr) * 2010-01-04 2012-11-08 Zyga Technology, Inc. Système de fusion sacro-iliaque
US9220554B2 (en) * 2010-02-18 2015-12-29 Globus Medical, Inc. Methods and apparatus for treating vertebral fractures
US20120022568A1 (en) * 2010-03-03 2012-01-26 Orthovita, Inc. Instrument for Use in Bone and Method of Use
EP2542165A4 (fr) 2010-03-05 2015-10-07 Arthrosurface Inc Système et procédé de resurfaçage tibial
US20130197553A1 (en) * 2010-03-30 2013-08-01 Siew Weng Ng Cutting device for cutting tissue
US10058336B2 (en) 2010-04-08 2018-08-28 Dfine, Inc. System for use in treatment of vertebral fractures
US20110251616A1 (en) * 2010-04-12 2011-10-13 K2M, Inc. Expandable reamer and method of use
CN102985015B (zh) 2010-04-29 2016-08-03 Dfine有限公司 用于治疗椎骨骨折的系统
EP2563233B1 (fr) 2010-04-29 2020-04-01 Dfine, Inc. Système destiné à être utilisé dans le traitement de fractures vertébrales
US9526507B2 (en) 2010-04-29 2016-12-27 Dfine, Inc. System for use in treatment of vertebral fractures
US8795369B1 (en) 2010-07-16 2014-08-05 Nuvasive, Inc. Fracture reduction device and methods
EP2642931B1 (fr) 2010-11-22 2017-03-15 Dfine, Inc. Système utilisable dans le cadre du traitement des fractures vertébrales
US20120185045A1 (en) * 2011-01-14 2012-07-19 Zimmer Spine, Inc. Articulating spinal implant insertion instrument
US9232957B2 (en) * 2011-02-04 2016-01-12 Athrex, Inc. Curved bur
BR112013022976A2 (pt) * 2011-03-11 2016-12-06 Smith & Nephew Inc instrumento de corte
US9066716B2 (en) 2011-03-30 2015-06-30 Arthrosurface Incorporated Suture coil and suture sheath for tissue repair
US8932295B1 (en) * 2011-06-01 2015-01-13 Surgical Device Exchange, LLC Bone graft delivery system and method for using same
US20130072941A1 (en) * 2011-09-16 2013-03-21 Francisca Tan-Malecki Cement Injector and Cement Injector Connectors, and Bone Cement Injector Assembly
US20130165982A1 (en) 2011-12-22 2013-06-27 Arthrosurface Incorporated System and Method for Bone Fixation
US10390877B2 (en) 2011-12-30 2019-08-27 Relievant Medsystems, Inc. Systems and methods for treating back pain
BR112014024028B1 (pt) 2012-03-27 2022-05-31 Dfine, Inc Dispositivo médico para criação de regiões de tecido aquecido utilizando temperatura para monitorar um perfil desejado das regiões
WO2014008126A1 (fr) 2012-07-03 2014-01-09 Arthrosurface Incorporated Système et procédé de resurfaçage et de réparation d'articulation
US10588691B2 (en) 2012-09-12 2020-03-17 Relievant Medsystems, Inc. Radiofrequency ablation of tissue within a vertebral body
IL238516B (en) 2012-11-05 2022-08-01 Relievant Medsystems Inc System and methods for creating curved pathways through bone and regulating the nerves within the bone
US10357259B2 (en) * 2012-12-05 2019-07-23 Smith & Nephew, Inc. Surgical instrument
US9918766B2 (en) 2012-12-12 2018-03-20 Dfine, Inc. Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement
US8945137B1 (en) 2013-03-15 2015-02-03 Surgical Device Exchange, LLC Bone graft delivery system and method for using same
US9668881B1 (en) 2013-03-15 2017-06-06 Surgentec, Llc Bone graft delivery system and method for using same
US9492200B2 (en) 2013-04-16 2016-11-15 Arthrosurface Incorporated Suture system and method
US9724151B2 (en) 2013-08-08 2017-08-08 Relievant Medsystems, Inc. Modulating nerves within bone using bone fasteners
WO2015057195A1 (fr) 2013-10-15 2015-04-23 Stryker Corporation Dispositif permettant de créer un espace vide dans un tissu vivant, comprenant une poignée dotée d'un bouton de commande qui peut être réglé quelle que soit l'orientation de la poignée
US9861375B2 (en) 2014-01-09 2018-01-09 Zyga Technology, Inc. Undercutting system for use in conjunction with sacroiliac fusion
US9962265B2 (en) 2014-03-07 2018-05-08 Arthrosurface Incorporated System and method for repairing articular surfaces
US10624748B2 (en) 2014-03-07 2020-04-21 Arthrosurface Incorporated System and method for repairing articular surfaces
US11607319B2 (en) 2014-03-07 2023-03-21 Arthrosurface Incorporated System and method for repairing articular surfaces
US9603607B2 (en) 2014-03-11 2017-03-28 Lenkbar, Llc Reaming instrument with adjustable profile
US9517076B2 (en) 2014-03-11 2016-12-13 Lenkbar, Llc Reaming instrument with adjustable profile
US9795395B2 (en) * 2014-06-10 2017-10-24 Medos International Sarl Retro-cutting instrument with adjustable limit setting
US9730707B2 (en) 2014-08-20 2017-08-15 Kyphon SÀRL Surgical instrument with graduated markings correlating to angulation
US10238507B2 (en) 2015-01-12 2019-03-26 Surgentec, Llc Bone graft delivery system and method for using same
WO2016172335A1 (fr) * 2015-04-22 2016-10-27 Stryker Corporation Ensemble canule d'accès pourvu d'un stylet comprenant un bras de verrouillage flexible
US9901392B2 (en) 2015-05-11 2018-02-27 Dfine, Inc. System for use in treatment of vertebral fractures
CA3003306C (fr) 2015-11-17 2019-04-16 Lenkbar, Llc Instrument de tunnellisation chirurgicale avec section extensible
US10492800B2 (en) * 2015-11-25 2019-12-03 Lenkbar, Llc Bone cutting instrument with expandable section
US10231846B2 (en) 2016-08-19 2019-03-19 Stryker European Holdings I, Llc Bone graft delivery loading assembly
WO2018081279A1 (fr) 2016-10-27 2018-05-03 Dfine, Inc. Ostéotome articulé avec canal de distribution de ciment
US11052237B2 (en) 2016-11-22 2021-07-06 Dfine, Inc. Swivel hub
US11026744B2 (en) 2016-11-28 2021-06-08 Dfine, Inc. Tumor ablation devices and related methods
WO2018107036A1 (fr) 2016-12-09 2018-06-14 Dfine, Inc. Dispositifs médicaux pour traiter des tissus durs et procédés associés
US10660656B2 (en) 2017-01-06 2020-05-26 Dfine, Inc. Osteotome with a distal portion for simultaneous advancement and articulation
US10456145B2 (en) 2017-05-16 2019-10-29 Arthrex, Inc. Expandable reamers
US10973558B2 (en) * 2017-06-12 2021-04-13 K2M, Inc. Screw insertion instrument and methods of use
WO2019028344A1 (fr) 2017-08-04 2019-02-07 Arthrosurface Incorporated Implant de surface articulaire à composants multiples
US11116647B2 (en) 2018-04-13 2021-09-14 Surgentec, Llc Bone graft delivery system and method for using same
US10687828B2 (en) 2018-04-13 2020-06-23 Surgentec, Llc Bone graft delivery system and method for using same
EP4603044A3 (fr) 2018-11-08 2025-12-10 Dfine, Inc. Systèmes d'ablation avec modulation basée sur des paramètres et dispositifs associés
USD948045S1 (en) 2018-12-13 2022-04-05 Spinal Generations, Llc Bone instrument shank
US11602357B2 (en) * 2018-12-13 2023-03-14 Spinal Generations, Llc Drill bit with delivery device fitting and method of use thereof
CN109431591B (zh) * 2018-12-20 2024-02-06 上海创辰生物科技有限公司 一种新型骨填充物输送系统
GB2616360B (en) 2019-03-12 2023-11-29 Arthrosurface Inc Humeral and glenoid articular surface implant systems and methods
US11849986B2 (en) 2019-04-24 2023-12-26 Stryker Corporation Systems and methods for off-axis augmentation of a vertebral body
KR102254320B1 (ko) * 2019-07-23 2021-06-22 오인수 경피적 척추 성형술용 본시멘트 주입장치
AU2020346827A1 (en) 2019-09-12 2022-03-31 Relievant Medsystems, Inc. Systems and methods for tissue modulation
US11986229B2 (en) 2019-09-18 2024-05-21 Merit Medical Systems, Inc. Osteotome with inflatable portion and multiwire articulation
WO2021087126A1 (fr) * 2019-10-30 2021-05-06 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital Système d'instrumentation de fusion vertébrale
AU2021306313A1 (en) 2020-07-10 2023-03-02 Relievant Medsystems, Inc. Vertebral denervation in conjunction with vertebral fusion
US20230338045A1 (en) * 2020-09-22 2023-10-26 Stryker Corporation Systems And Methods For Augmentation Of A Vertebral Body
US12082876B1 (en) 2020-09-28 2024-09-10 Relievant Medsystems, Inc. Introducer drill
US12262927B2 (en) 2020-12-10 2025-04-01 K2M, Inc. Screw insertion instrument and methods of use
EP4268150A4 (fr) 2020-12-22 2024-12-18 Relievant Medsystems, Inc. Prédiction de candidats pour la neuromodulation de la moëlle épinière
US12433668B1 (en) 2021-11-08 2025-10-07 Relievant Medsystems, Inc. Impedance stoppage mitigation during radiofrequency tissue ablation procedures

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999051149A1 (fr) * 1998-04-06 1999-10-14 Kyphon Inc. Structures et procedes pour former des cavites dans des regions corporelles internes
US20060116689A1 (en) * 2004-06-16 2006-06-01 Sdgi Holdings, Inc. Surgical instrumentation and method for treatment of a spinal structure
US20060184188A1 (en) * 2002-11-08 2006-08-17 Li Lehmann K Transpedicular intervertebral disk access methods and devices
US20060264957A1 (en) * 2000-02-16 2006-11-23 Trans1, Inc. Apparatus for performing a discectomy through a trans-sacral axial bore within the vertebrae of the spine

Family Cites Families (32)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4969888A (en) 1989-02-09 1990-11-13 Arie Scholten Surgical protocol for fixation of osteoporotic bone using inflatable device
US5015255A (en) 1989-05-10 1991-05-14 Spine-Tech, Inc. Spinal stabilization method
CA2007210C (fr) 1989-05-10 1996-07-09 Stephen D. Kuslich Trepan aleseur intervertebral
DE3922044A1 (de) 1989-07-05 1991-02-07 Richter Turtur Matthias Dr Instrumentarium zur wirbelbruchbehandlung
US5059193A (en) 1989-11-20 1991-10-22 Spine-Tech, Inc. Expandable spinal implant and surgical method
US5292330A (en) 1990-05-31 1994-03-08 Linvatec Corporation Retractable surgical instrument with curved operative element
US5390683A (en) 1991-02-22 1995-02-21 Pisharodi; Madhavan Spinal implantation methods utilizing a middle expandable implant
ES2287635T3 (es) 1994-01-26 2007-12-16 Kyphon Inc. Dispositivo inflamable mejorado para uso en metodos quirurgicos relacinados a la fijacion de hueso.
US5571189A (en) 1994-05-20 1996-11-05 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
EP0925033B1 (fr) 1996-07-18 2004-02-25 Implant Innovations, Inc. Outils d'osteotome motorises de tassement des tissus osseux
IL128261A0 (en) 1999-01-27 1999-11-30 Disc O Tech Medical Tech Ltd Expandable element
US5928239A (en) 1998-03-16 1999-07-27 University Of Washington Percutaneous surgical cavitation device and method
US6224604B1 (en) 1999-07-30 2001-05-01 Loubert Suddaby Expandable orthopedic drill for vertebral interbody fusion techniques
US6383188B2 (en) 2000-02-15 2002-05-07 The Spineology Group Llc Expandable reamer
EP1309280A2 (fr) 2000-08-11 2003-05-14 SDGI Holdings, Inc. Instrumentation chirurgicale et procede de traitement du rachis
US7114501B2 (en) 2000-08-14 2006-10-03 Spine Wave, Inc. Transverse cavity device and method
US6679886B2 (en) 2000-09-01 2004-01-20 Synthes (Usa) Tools and methods for creating cavities in bone
US6746451B2 (en) 2001-06-01 2004-06-08 Lance M. Middleton Tissue cavitation device and method
US6814734B2 (en) 2001-06-18 2004-11-09 Sdgi Holdings, Inc, Surgical instrumentation and method for forming a passage in bone having an enlarged cross-sectional portion
JP4499327B2 (ja) 2001-12-06 2010-07-07 松崎 浩巳 拡径器具および手術器具セット
US20040010315A1 (en) 2002-03-29 2004-01-15 Song John K. Self-expanding intervertebral device
US7329267B2 (en) 2002-12-23 2008-02-12 Boston Scientific Scimed, Inc. Medical cutting devices and methods of use
WO2004093637A2 (fr) 2003-04-17 2004-11-04 Secant Medical, Llc Outil a lame de coupe pouvant etre deployee
US20050113836A1 (en) 2003-11-25 2005-05-26 Lozier Antony J. Expandable reamer
US7641664B2 (en) 2004-02-12 2010-01-05 Warsaw Orthopedic, Inc. Surgical instrumentation and method for treatment of a spinal structure
AU2004319780A1 (en) 2004-05-19 2005-11-24 Sintea Biotech S.P.A Intravertebral widening device, injection device, and kit and method for kyphoplasty
WO2006034436A2 (fr) 2004-09-21 2006-03-30 Stout Medical Group, L.P. Dispositif de support expansible et procede d'utilisation
US7731751B2 (en) 2005-03-31 2010-06-08 Life Spine, Inc. Expandable spinal devices and method of insertion
US20070067034A1 (en) 2005-08-31 2007-03-22 Chirico Paul E Implantable devices and methods for treating micro-architecture deterioration of bone tissue
US20070123889A1 (en) 2005-10-14 2007-05-31 Malandain Hugues F Mechanical cavity-creation surgical device and methods and kits for using such devices
US20080009877A1 (en) 2006-07-07 2008-01-10 Meera Sankaran Medical device with expansion mechanism
US20080114364A1 (en) 2006-11-15 2008-05-15 Aoi Medical, Inc. Tissue cavitation device and method

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999051149A1 (fr) * 1998-04-06 1999-10-14 Kyphon Inc. Structures et procedes pour former des cavites dans des regions corporelles internes
US20060264957A1 (en) * 2000-02-16 2006-11-23 Trans1, Inc. Apparatus for performing a discectomy through a trans-sacral axial bore within the vertebrae of the spine
US20060184188A1 (en) * 2002-11-08 2006-08-17 Li Lehmann K Transpedicular intervertebral disk access methods and devices
US20060116689A1 (en) * 2004-06-16 2006-06-01 Sdgi Holdings, Inc. Surgical instrumentation and method for treatment of a spinal structure

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018195406A1 (fr) 2017-04-21 2018-10-25 Stryker Corporation Système de stabilisation et implant pour empêcher un mouvement relatif entre des sections de tissu
US11452548B2 (en) 2017-04-21 2022-09-27 Stryker Corporation Stabilization system, implant, and methods for preventing relative motion between sections of tissue
EP4245234A2 (fr) 2017-04-21 2023-09-20 Stryker Corporation Système de stabilisation et implant pour empêcher un mouvement relatif entre des sections de tissu
US12268423B2 (en) 2017-04-21 2025-04-08 Stryker Corporation Stabilization system, implant, and methods for preventing relative motion between sections of tissue
WO2020023271A1 (fr) * 2018-07-27 2020-01-30 Warsaw Orthopedic, Inc. Système et procédé d'implant rachidien
WO2023114949A1 (fr) 2021-12-16 2023-06-22 Sana Biotechnology, Inc. Procédés et systèmes de production de particules

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